On July 23rd, the medical journal The Lancet published An open letter for the people in Gaza. In so doing, the journal betrayed what it calls its prestigious heritage as one of the world's leading medical journals [which] continues to inspire our authors and editors today as they strive for medical excellence in all that they publish. There is neither medical nor journalistic excellence in the piece. Instead, it is little more than an anti-Israel screed replete with mischaracterizations, important omissions, flat out falsehoods and unsubstantiated accusations.

This is not surprising coming from The Lancet which has a sad history of publishing anti-Israel pieces, some by the very same authors who wrote this one. CAMERA has documenteda number of these in the past. Richard Horton, the journal's editor, has also exhibited an anti-Israel bias in other publications.

Self-Defense, Not Aggression

The Lancet piece frames the current conflict and ongoing tensions between Israel and Hamas as Israeli aggression.

It is not aggression to respond to thousands of rockets and missiles fired indiscriminately at civilian population centers. It is not aggression to seek to destroy an elaborate network of tunnels and an underground infrastructure designed exclusively to perpetrate terrorist attacks upon Israeli citizens including large-scale massacres and kidnappings.

Efforts to protect its citizens are the first duty of a nation. Article 51 of the United Nations charter specifically codifies the inherent right of self-defense against armed attack. No nation can tolerate incessant rocket attacks from neighboring territories. The vast majority of Israeli residents have only seconds to find shelter when the sirens sound warning of incoming attacks as far north as Haifa.

Targeting civilians in this way is a war crime as even Ibrahim Khreiseh, PLO Ambassador to the UN Human Rights Council has admitted is the case. He said the Hamas missiles now being launched against Israel  each and every missile constitutes a crime against humanity, because it is directed at civilian targets.

Civilian Casualties and Human Shields

The authors claim, This is the third large scale military assault on Gaza since 2008. Each time the death toll is borne mainly by innocent people in Gaza, especially women and children. Of course, the current conflict is a response to the onslaught of missiles fired at millions of Israeli civilian targets.

Moreover, the death toll is not borne mainly by innocents. Detailed and precise casualty figures are obviously not yet available for Operation Protective Edge, but preliminary studies indicate that it is not accurate to say that casualties are mainly non-combatants.

A July 29 Time.com article by CAMERA makes clear the preponderance of fighting age males among the fatalities.

Certainly, studies of the previous Gaza operations, Cast Lead and Pillar of Defense, prove that the Israel Defense Forces (IDF) achieved a ratio of civilian to combatant casualties vastly lower than any other military on earth.

Of Operation Cast Lead, Colonel Richard Kemp, former commander of British Forces in Afghanistan, wrote in the Jerusalem Post:

The UN estimate that there has been an average three-to one ratio of civilian to combatant deaths in such conflicts worldwide. Three civilians for every combatant killed.

That is the estimated ratio in Afghanistan: three to one.

In Iraq, and in Kosovo, it was worse: the ratio is believed to be four-to-one. Anecdotal evidence suggests the ratios were very much higher in Chechnya and Serbia.

In Gaza, it was less than one-to-one.

During Pillar of Defense the ratio was lower still, less than one-to-one. This is because the IDF undertakes measures not commonly used by other militaries, including dropping leaflets, phoning and texting warnings to civilians in conflict zones. The IDF also calls off strikes when they detect civilians and even drops non-lethal charges as warning knocks on the roof alerting civilians to vacate targeted buildings. Of these measures, Colonel Kemp stated only last week:

I believe that on the basis of everything that I've seen, that everything the IDF does to protect civilians and to stop the death of innocent civilians is a great deal more than any other army, and it's more than the British and the American armies.

Tragically, civilians are killed in all conflicts. But Israel does not target civilians.

This is not the case with Hamas, a genocidal terrorist group the charter of which commits it to the destruction of Israel and the murder of all Jews. Not only do Hamas terrorists strive to hit Israeli civilians with their rockets and missiles, they recently abducted and murdered three Israeli teens and have carried out attacks that have killed hundreds of Israelis in the past.

More gruesome still is Hamas' use of Gaza civilians as human shields, these being the very people Hamas claims to be defending. There are reports of Hamas and Islamic Jihad ferrying weapons, ammunition and fighters around the Strip in ambulances filled with children. The United Nations has strongly condemned the storage of rockets in at least three schools the UN runs in Gaza. Even members of Congress across the political spectrum, who agree on very little, are condemning Hamas use of civilians as human shields.

Journalists in Gaza have tweeted about Hamas firing from civilian areas. A Canadian TV reporter tweeted she witnessed a fighter who passed dressed in a woman's headscarf... tip of a gun poked out from under cloak. These journalists are threatened by Hamas and some subsequently delete the tweets, apparently in fear.

There can be no dispute about the fact that Hamas encourages civilians to act as human shields. The group's own spokesman Sami Abu Zuhri bragged about it and encouraged the practice in an interview aired on Al-Aqsa TV. (Watch the video here.) Asked by an interviewer about the practice of civilians returning to the rooftops of buildings after warnings by the IDF that these buildings would be targeted, Abu Zuhri says:

The policy of people confronting the Israeli warplanes with their bare chests in order to protect their homes has proven effective against the occupation. Also, this policy [acting as human shields] reflects the character of our brave, courageous people. We in Hamas call upon our people to adopt this policy, in order to protect the Palestinian homes.

This is a long-standing Hamas policy. In 2008 Hamas member of the Palestinian Legislative Council, Fathi Hammad,said:

For the Palestinian people death became an industry at which women excel and so do all people on this land: the elderly excel, the Jihad fighters excel, and the children excel. Accordingly [Palestinians] created a human shield of women, children, the elderly and the Jihad fighters against the Zionist bombing machine, as if they were saying to the Zionist enemy: We desire Death, as you desire Life.

The Blockade Fallacy

The Lancet Op-Ed claims:

Gaza has been blockaded by sea and land since 2006. Any individual of Gaza, including fishermen venturing beyond 3 nautical miles of the coast of Gaza, face being shot by the Israeli Navy. No one from Gaza can leave from the only two checkpoints, Erez or Rafah, without special permission from the Israelis and the Egyptians, which is hard to come by for many, if not impossible. People in Gaza are unable to go abroad to study, work, visit families, or do business. Wounded and sick people cannot leave easily to get specialised treatment outside Gaza. Entries of food and medicines into Gaza have been restricted and many essential items for survival are prohibited. Before the present assault, medical stock items in Gaza were already at an all time low because of the blockade

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Much of Gaza's buildings and infrastructure had been destroyed during Operation Cast Lead, 200809, and building materials have been blockaded so that schools, homes, and institutions cannot be properly rebuilt. Factories destroyed by bombardment have rarely been rebuilt adding unemployment to destitution.

Space does not allow for full rebuttal of all the fallacies in the above. We will counter just a few.

Israel left Gaza in 2005. But the blockade did not begin until a year later. Why is that? Because until then, Hamas had not taken over the Strip and begun shooting rockets and missiles at Israeli civilians. At that point, it became necessary for Israel to control the influx of weapons and materials used to build the rockets. The blockade is completely legal according to international law. Even the UN's Palmer Report affirmed this legality.

Until the recent conflict, fisherman were not limited to three miles off the coast but double that. Egypt and Israel have every right to control their border crossings as does every sovereign state. Wounded and sick people not only leave Gaza to get treatment, they are treated in Israeli hospitals. The wife of Palestinian Authority President Mahmoud Abbas and the granddaughter of Hamas leader Ismail Haniyeh both received treatment in Israeli hospitals recently.

Entries of food, medicines and other essential items are not only permitted by Israel, they are facilitated by Israel which monthly trucks literally tons of goods into Gaza. Even during this conflict, Israel has been moving food, medicine and fuel into the Strip. What other nation would literally fuel its enemies?

As for building materials, Israel has been allowing concrete, steel and other building materials into Gaza for years. Since the discovery of the vast network of tunnels and bunkers built by Hamas underground, it is clear that if schools, homes and factories have not been built, it is because the Hamas regime has using these supplies to create a terrorist infrastructure rather than to service the needs of its people.

There are many more inaccurate statements, unsubstantiated allegations and hateful charges leveled in the piece.